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γ-Glutamyl Transferase as a Risk Factor for All-Cause or Cardiovascular Disease Mortality Among 5912 Ischemic Stroke
Wen-Jun Tu1, Qiang Liu2, Jian-Lei Cao1
1From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing (W.-J.T., S.-J.Z.); Department of Cardiology, Zhongnan Hospital of Wuhan University, China (J.-L.C.); and Department of Neurosurgery, Affiliated Hospital of Weifang Medical College, China (X.-W.Z., A.-J.D.).
Insights
High serum gamma-glutamyl transferase (GGT) levels at admission are linked to increased 1-year mortality risk in acute ischemic stroke patients. This finding highlights GGT as a significant predictor of both all-cause and cardiovascular disease death.
Area of Science:
- Neurology
- Cardiology
- Biochemistry
Background:
- Serum gamma-glutamyl transferase (GGT) is an enzyme with potential implications in cardiovascular health.
- Elevated GGT levels have been observed in various disease states, but their prognostic value in acute ischemic stroke is not fully elucidated.
Purpose of the Study:
- To investigate the association between serum GGT concentrations upon admission and 1-year mortality in patients diagnosed with acute ischemic stroke.
- To determine if GGT can serve as an independent predictor of all-cause and cardiovascular disease (CVD) mortality.
Main Methods:
- A prospective, multicenter cohort study involving 5912 patients with acute ischemic stroke across four stroke centers in China.
- Serum GGT levels were measured at admission, and patients were followed for 1 year to record all-cause and CVD mortality.
- Statistical analyses, including hazard ratios and area under the curve (AUC) for predictive ability, were employed.
Main Results:
- High serum GGT levels were significantly associated with increased 1-year all-cause and CVD mortality in both male and female patients (P<0.001).
- Elevated GGT demonstrated adjusted hazard ratios of 3.03 for all-cause mortality and 3.24 for CVD mortality.
- GGT showed significant discriminatory ability for predicting all-cause mortality (AUC=0.69) and improved the predictive power of the National Institutes of Health Stroke Scale score (combined AUC=0.75).
Conclusions:
- Serum GGT concentration at admission is an independent predictor of 1-year all-cause and CVD mortality in patients with acute ischemic stroke.
- GGT measurement offers valuable prognostic information and may enhance risk stratification tools for stroke patients.
Background And Purpose:
The aim of the study was to evaluate the association of the measurement of serum γ-glutamyl transferase (GGT) concentrations at admission with 1-year all-cause or cardiovascular disease (CVD) mortality in patients with acute ischemic stroke.
Methods:
This prospective, multicenter cohort study was conducted in 4 stroke centers in China. Baseline GGT measurements were tested. The relationship of GGT to the risk of death from all-cause or CVD was examined among 1-year follow-up patients.
Results:
We recorded results from 5912 patients with stroke. In those patients, 51.0% were men, and the median age was 61 years. In both men and women, high GGT was significantly associated with total mortality from all-cause or CVD (P<0.001). The elevated GGT revealed adjusted hazard ratios (95% confidence interval) of 3.03 (1.99-4.54) and 3.24 (2.14-4.92) for mortality from all-cause and CVD, respectively. With an area under the curve of 0.69 (95% confidence interval, 0.66-0.73), GGT showed a significantly greater discriminatory ability to predict all-cause mortality as compared with others factors. GGT improved the National Institutes of Health Stroke Scale score (area under the curve of the combined model, 0.75 [95% confidence interval, 0.73-0.78]; P<0.01).
Conclusions:
This study demonstrates that GGT is independently associated with all-cause and CVD mortality in patients with ischemic stroke.
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